California Workers' Comp

CA Providers: Good Luck Fighting MPN Payment Denials

Yesterday, daisyNews shared data on payment denials citing non-membership in Medical Provider Networks (MPNs) and, in multiple cases, showed that ...

CA: Suspicious MPN Payment Denials Are Rampant

In California, Medical Provider Networks (MPNs) theoretically allow employers and their comp insurers to ensure that injured workers receive appropriate care at reasonable co...

CA Billing Alert: Alisal Union Schools’ TPA Pays Below Medicare Rates

California’s fee schedule for workers’ comp treatment pays physicians more than Medicare rates (currently 55% more) to account for the extraordinary time, work, and administr...

Liberty Mutual Plays “IBR (and IMR) Chicken” on UPS Claim

Two unfortunate necessities exemplify the broken state of California’s dysfunctional workers’ comp system:Too often, payers deny an injured worker's care, and the work...

CA DWC: Providers Must Use RFA Form (While Payers Can Do What They Please)

In California, before treating an injured worker, a physician must obtain prior approval from the payer for all treatment. The California Division of Workers’ Compensation (C...

CA EOR Trap #1: ECHO Withholds EORs as Bait for MPX Sales Pitch

Payment processing vendor ECHO Health is withholding Explanations of Review from California workers' compensation providers. ECHO then uses the missing EORs as bait to compel...

Data: PPOs Are Another “Cost Control” Measure That Hurts CA Employers

California employers pay more than almost any other state for comp coverage, with premiums set to rise again in September. California claims take twice as long and cost twice...

The Hartford Ignores Its Own Authorization (Again)

When an employer pays The Hartford its workers’ comp premiums, the expectation is simple: The Hartford will pay for injured employees’ treatment and benefits. But this week, ...

The Hartford’s Authorization Exposes “Pay to Treat” System

California employers pay insurers like The Hartford to ensure that when one of their employees sustains a work injury, the providers who treat them get paid. Instead, ...

The Hartford Denies Payment With Bogus MPN Claim

As daisyNews frequently explains, California's Medical Provider Network (MPN) system accomplishes nothing other than making treatment less accessible for injured worke...

NY WCB Is Right to Celebrate. What Can CA Learn?

New York's Workers' Compensation Board (NY WCB) recently issued a bulletin touting its accomplishments over the last several years. While it’s hard not to be skeptical of a g...

CA MPNs: The "Cost Control" Tool That Costs Employers More

In a workers’ comp claim, the treating physician is the single most consequential factor in health outcomes, the duration of disability payments, and employer liability. ...